Comparison of Two Sedation Protocols for Postoperative Intensive Care Unit Care after Head and Neck Reconstructive Surgery: Midazolam/Morphine versus Remifentanil Sedation.
10.3342/kjorl-hns.2014.57.3.172
- Author:
Nak Joon LEE
1
;
Jeon Yeob JANG
;
Sung Yong CHOI
;
Ki Nam PARK
;
Chung Hwan BAEK
;
Jun Seo PARK
;
Sook Hyun PARK
;
Han Sin JEONG
Author Information
1. Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hansin.jeong@gmail.com
- Publication Type:Original Article
- Keywords:
Free flap;
Head and neck surgery;
Postoperative care;
Reconstruction;
Sedation
- MeSH:
Blood Pressure;
Delirium;
Free Tissue Flaps;
Head and Neck Neoplasms;
Head*;
Humans;
Intensive Care Units*;
Critical Care*;
Length of Stay;
Neck*;
Nursing;
Postoperative Care;
Retrospective Studies;
Vital Signs
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2014;57(3):172-177
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: In head and neck reconstructive surgery, the stability of vital signs is important for patient recovery and flap outcome. We aimed to determine the better sedation protocol by comparing two protocols, namaely, midazolam/morphine (MM)-based and remifentanil (RF)-based sedation protocols, in the immediate postoperative settings of head and neck reconstructive surgery. SUBJECTS AND METHOD: We retrospectively reviewed the medical data of patients who underwent reconstructive surgery after the ablation of head and neck cancer involving MM sedation (n=34) or RF sedation (n=28). Parameters related to vital signs, flap outcomes, occurrence of delirium, length of stay and nursing burden were compared between the groups. RESULTS: The length of stay at the intensive care unit and flap outcomes were similar in the two groups. However, blood pressure as measured by frequency of variation was more stable in the RF group than in the MM group. In addition, the number of medical calls from the attending nurse due to the fluctuation of vital signs was less in the RF group than in the MM group. CONCLUSION: RF-based sedation for the postoperative intensive care unit care after head and neck reconstructive surgery is more effective in cases where vital signs are less stable. This type of sedation may decrease the nursing burden for these patients.
